Hunt Permit-Tag Surrender

Donate your hunt permit-tag to Camp Hero Arizona. We handle submission to AZGFD on your behalf. All donations are tax-deductible as Camp Hero Arizona is a 501(c)(3) nonprofit (Tax ID: 84-2809677).

APPLICATION FOR

HUNT PERMIT-TAG SURRENDER

Arizona Game and Fish Department ◆ 5000 W. Carefree Hwy. ◆ Phoenix, AZ 85086 ◆ 602-942-3000

ARIZONA
GAME
& FISH

Applicant must have purchased PointGuard for the species applied for in the draw in which the hunt permit-tag being surrendered was drawn. Only one hunt permit-tag may be surrendered, per species. If an applicant is drawn in the future for that particular species, that hunt permit-tag must be used, expending all accumulated bonus points. Only then may an applicant participate again in PointGuard. The original tag and this form must be received at an AZGFD office no later than 5:00 pm the day before the hunt begins. The applicant understands that upon surrender of an E-tag it will no longer be issued to applicant and will be invalid for applicants use in accordance with R12-4-118.

Camp Hero Arizona: Complete this form to donate your tag to Camp Hero. We handle submission to AZGFD. Contact: [email protected] | (602) 930-5007

APPLICANT INFORMATION

(PLEASE PRINT CLEARLY)

Name: *

(Current mailing address or physical location of residence.)

Address: *

City: *

State:

Zip Code:

Phone Number: *

Date of birth:

Customer ID number:

Hunt number: *

Check box for E-Tag

Permit-Tag number: *

E-mail address: *

Was this tag donated to a non-profit organization? Yes No

(If Yes, please also provide the “Hunt Permit-Tag Donation Affidavit” - Form 132.)

Signature of Applicant

Date

Please submit tag and this completed form to any Arizona Game and Fish office. Visit https://www.azgfd.com/Agency/Offices for a list of our locations. Si desea hablar con un representante de servicio al cliente bilingüe para obtener información llame al (602) 942-3000 de lunes a viernes de 8:00 a.m. A 5:00 p. Y luego ingrese el número, 5 durante el mensaje grabado.

DEPARTMENT USE ONLY

Date Received(Please forward form and tag to SSDW.)

Clerk's name and work unit

SSDW_Form 131_09072022

Camp Hero Additional Info

Species (for Camp Hero records):

I would like a tax-deductible receipt

Camp Hero Arizona 501(c)(3) — Tax ID: 84-2809677

Estimated Fair Market Value of Tag: